Hepatitis B Reactivation Rate and Fate Among Multiple Myeloma Patients Receiving Regimens Containing Lenalidomide and/or Bortezomib
Yıl: 2019 Cilt: 36 Sayı: 4 Sayfa Aralığı: 266 - 273 Metin Dili: İngilizce DOI: 10.4274/tjh.galenos.2019.2019.0103 İndeks Tarihi: 20-08-2020
Hepatitis B Reactivation Rate and Fate Among Multiple Myeloma Patients Receiving Regimens Containing Lenalidomide and/or Bortezomib
Öz: Objective: Reactivation of the hepatitis B virus (HBV) refers to anincrease in HBV replication in a patient with inactive or resolvedHBV. In this retrospective study, our aim is to present and compareHBV reactivation in multiple myeloma (MM) patients who receivedlenalidomide and/or bortezomib at any time during treatment,evaluate the factors associated with reactivation, and demonstratethe outcome of patients.Materials and Methods: We evaluated 178 MM patients whoreceived lenalidomide (n=102) and/or bortezomib (n=174) duringtheir treatment schedules. The HBsAg, anti-HBc, anti-HBs, HBeAg,and anti-HBe were detected by chemiluminescence by ARCHITECT labanalyzers using commercially available kits (Abbott, USA). HBV-DNAtiters were determined by quantitative PCR. The results were evaluatedby IBM SPSS Statistics for Windows, Version 20.0 (IBM Corp., Armonk,NY, USA).Results: HBV reactivation was diagnosed in 6 patients (3%)after bortezomib and in 8 patients (8%) after bortezomib andlenalidomide. Three of the patients in each group had HBsAg+,HBeAg+, AntiHBeAg-, AntiHBc-, and AntiHBS+ status, whereas 5patients in the bortezomib- and lenalidomide-treated group and3 patients in the bortezomib-treated group had HBsAg-, HBeAg-,AntiHBeAg-, AntiHBc-, and AntiHBS+ status prior to treatment. Therewere no statistical differences observed between HBV reactivationin the bortezomib-treated or bortezomib- and lenalidomide-treatedgroups in terms of age at diagnosis, sex, International Staging Systemsubtype, frequency of extramedullary disease, dialysis requirement,or receiving of autologous stem cell transplantation. In patients whoreceived antiviral prophylaxis, a higher incidence of HBV reactivationwas detected in HBsAg-positive patients compared to HBsAg-negativepatients (4/4, 100% vs. 2/7, 29%; p=0.045). The 3-year and 5-year overall survival rates were similar in patients with or without HBVreactivation (83% vs. 84%, 73% vs. 74%, p=0.84).Conclusion: Close follow-up is recommended for not only HBsAgpositive but also HBsAg-negative patients.
Anahtar Kelime: Lenalidomid ve/veya Bortezomib İçeren Tedavi Alan Multipl Myelom Hastalarında Hepatit B Reaktivasyon Sıklığı ve Sonuçları
Öz: Amaç: Hepatit B virüs (HBV) reaktivasyonu, HBV enfeksiyonunun inaktifleştiği veya iyileştiği hastalarda virüs replikasyonunun artışıdır. Bu geriye dönük çalışmada amacımız tedavilerinin herhangi bir döneminde lenalidomid ve/veya bortezomib alan multipl myelom (MM) hastalarında HBV reaktivasyonunu göstermek, reaktivasyonla ilişkili faktörleri ve sağkalımlarını değerlendirmektir. Gereç ve Yöntemler: Tedavileri sırasında lenalidomid (n=102) ve/ veya bortezomib (n=174) alan 178 MM hastası değerlendirilmiştir. ARCHITECT lab analiz cihazlarıyla HBsAG, anti-HBc, anti-HBs, HBeAg, anti-HBe piyasada bulunan kitlerle (Abbott, ABD) kemiluminesans yoluyla, HBV-DNA titreleri kuantitative PCR ile tespit edilmiştir. Sonuçların değerlendirilmesinde IBM SPSS 20.0 (IBM Corp., Armonk, NY, ABD) kullanılmıştır. Bulgular: HBV reaktivasyonu, bortezomib kullanan 6 hastada (%3) ile bortezomib ve lenalidomid alan 8 hastada (%8) tespit edilmiştir. Tedavi öncesi iki gruptan 3 hastada HBsAg+, HBeAg+, AntiHBeAg-, AntiHBc-, ve AntiHBS+ saptanırken, bortezomib ve lenalidomid alan 5 hastada ve sadece bortezomib alan 3 hastada HBsAg-, HBeAg-, AntiHBeAg-, AntiHBc-, ve AntiHBS+ saptanmıştır. Bortezomib veya bortezomib ve lenalidomid ile tedavi edilen gruplar arasında HBV reaktivasyonu ile tanı anındaki yaş, cinsiyet, evre, ekstramedüllar hastalık, diyaliz ihtiyacı veya otolog kök hücre nakil sıklığı arasında istatistiksel olarak fark saptanmamıştır. Antiviral profilaksi alan grupta, HBsAg pozitif olan hastalarda HBsAg negatif olan hastalara göre daha sık HBV reaktivasyonu tespit edilmiştir (4/4, %100 ile 2/7, %29; p=0,045). HBV reaktivasyonu gelişen ve gelişmeyen hastalarda 3-yıllık ve 5 yıllık sağkalımlar benzerdir (%83 ile %84, %73 ile %74, p=0,84). Sonuç: Sadece HBsAg pozitif hastalar değil HBsAg negatif hastalar da yakından takip edilmelidir.
Anahtar Kelime: Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
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| APA | ATACA P, Yalçıner M, Atilla E, Idilman R, Beksac M (2019). Hepatitis B Reactivation Rate and Fate Among Multiple Myeloma Patients Receiving Regimens Containing Lenalidomide and/or Bortezomib. , 266 - 273. 10.4274/tjh.galenos.2019.2019.0103 |
| Chicago | ATACA PINAR,Yalçıner Merih,Atilla Erden,Idilman Ramazan,Beksac Meral Hepatitis B Reactivation Rate and Fate Among Multiple Myeloma Patients Receiving Regimens Containing Lenalidomide and/or Bortezomib. (2019): 266 - 273. 10.4274/tjh.galenos.2019.2019.0103 |
| MLA | ATACA PINAR,Yalçıner Merih,Atilla Erden,Idilman Ramazan,Beksac Meral Hepatitis B Reactivation Rate and Fate Among Multiple Myeloma Patients Receiving Regimens Containing Lenalidomide and/or Bortezomib. , 2019, ss.266 - 273. 10.4274/tjh.galenos.2019.2019.0103 |
| AMA | ATACA P,Yalçıner M,Atilla E,Idilman R,Beksac M Hepatitis B Reactivation Rate and Fate Among Multiple Myeloma Patients Receiving Regimens Containing Lenalidomide and/or Bortezomib. . 2019; 266 - 273. 10.4274/tjh.galenos.2019.2019.0103 |
| Vancouver | ATACA P,Yalçıner M,Atilla E,Idilman R,Beksac M Hepatitis B Reactivation Rate and Fate Among Multiple Myeloma Patients Receiving Regimens Containing Lenalidomide and/or Bortezomib. . 2019; 266 - 273. 10.4274/tjh.galenos.2019.2019.0103 |
| IEEE | ATACA P,Yalçıner M,Atilla E,Idilman R,Beksac M "Hepatitis B Reactivation Rate and Fate Among Multiple Myeloma Patients Receiving Regimens Containing Lenalidomide and/or Bortezomib." , ss.266 - 273, 2019. 10.4274/tjh.galenos.2019.2019.0103 |
| ISNAD | ATACA, PINAR vd. "Hepatitis B Reactivation Rate and Fate Among Multiple Myeloma Patients Receiving Regimens Containing Lenalidomide and/or Bortezomib". (2019), 266-273. https://doi.org/10.4274/tjh.galenos.2019.2019.0103 |
| APA | ATACA P, Yalçıner M, Atilla E, Idilman R, Beksac M (2019). Hepatitis B Reactivation Rate and Fate Among Multiple Myeloma Patients Receiving Regimens Containing Lenalidomide and/or Bortezomib. Turkish Journal of Hematology, 36(4), 266 - 273. 10.4274/tjh.galenos.2019.2019.0103 |
| Chicago | ATACA PINAR,Yalçıner Merih,Atilla Erden,Idilman Ramazan,Beksac Meral Hepatitis B Reactivation Rate and Fate Among Multiple Myeloma Patients Receiving Regimens Containing Lenalidomide and/or Bortezomib. Turkish Journal of Hematology 36, no.4 (2019): 266 - 273. 10.4274/tjh.galenos.2019.2019.0103 |
| MLA | ATACA PINAR,Yalçıner Merih,Atilla Erden,Idilman Ramazan,Beksac Meral Hepatitis B Reactivation Rate and Fate Among Multiple Myeloma Patients Receiving Regimens Containing Lenalidomide and/or Bortezomib. Turkish Journal of Hematology, vol.36, no.4, 2019, ss.266 - 273. 10.4274/tjh.galenos.2019.2019.0103 |
| AMA | ATACA P,Yalçıner M,Atilla E,Idilman R,Beksac M Hepatitis B Reactivation Rate and Fate Among Multiple Myeloma Patients Receiving Regimens Containing Lenalidomide and/or Bortezomib. Turkish Journal of Hematology. 2019; 36(4): 266 - 273. 10.4274/tjh.galenos.2019.2019.0103 |
| Vancouver | ATACA P,Yalçıner M,Atilla E,Idilman R,Beksac M Hepatitis B Reactivation Rate and Fate Among Multiple Myeloma Patients Receiving Regimens Containing Lenalidomide and/or Bortezomib. Turkish Journal of Hematology. 2019; 36(4): 266 - 273. 10.4274/tjh.galenos.2019.2019.0103 |
| IEEE | ATACA P,Yalçıner M,Atilla E,Idilman R,Beksac M "Hepatitis B Reactivation Rate and Fate Among Multiple Myeloma Patients Receiving Regimens Containing Lenalidomide and/or Bortezomib." Turkish Journal of Hematology, 36, ss.266 - 273, 2019. 10.4274/tjh.galenos.2019.2019.0103 |
| ISNAD | ATACA, PINAR vd. "Hepatitis B Reactivation Rate and Fate Among Multiple Myeloma Patients Receiving Regimens Containing Lenalidomide and/or Bortezomib". Turkish Journal of Hematology 36/4 (2019), 266-273. https://doi.org/10.4274/tjh.galenos.2019.2019.0103 |
